Sequential vascularized iliac bone graft and a superficial circumflex iliac artery perforator flap with a single source vessel for established mandibular defects

Isao Koshima, Yuzaburo Namba, Tetsuya Tsutsui, Seiko Itoh

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The major problems in dealing with established mandibular loss are severe soft-tissue contracture and a limited number of recipient vessels. The skin portion of the iliac osteocutaneous flap often necrotizes in cases without perforators of the deep circumflex iliac vessel. To overcome these problems, eight patients with established mandibular loss and no skin perforators of the deep circumflex iliac vessel were treated with a sequential vascularized iliac bone graft and a superficial circumflex iliac perforator flap with a single recipient vessel. Regarding the recipient vessels, the ipsilateral cervical vessels were used for four patients, and the contralateral facial and ipsilateral superficial temporal vessels were used for two cases each. The superficial circumflex iliac perforator flaps were 7 to 28 cm in length and 3 to 15 cm in width. The iliac bone grafts ranged from 7 to 13 cm in length, and three cases were repaired with the inner cortex of the iliac bone. There were no serious complications, such as flap necrosis or bone infection and resulting absorption. The advantages of this method are that both pedicles are very close to each other and of suitable diameter for anastomosis. Simultaneous flap elevation and preparation for the recipient site is possible. The skin flap and vascularized bone graft can be obtained from the same donor site. A single source vessel can nourish both the large skin area and bone sequentially. Longer dissection of the superficial circumflex iliac system to the proximal femoral division is unnecessary. A large flap can survive with a short segment of the superficial circumflex iliac system. Only the vascularized inner cortex of the iliac bone needs to be used, and the outer iliac cortex can be preserved, which results in less morbidity at the donor site.

Original languageEnglish
Pages (from-to)101-106
Number of pages6
JournalPlastic and Reconstructive Surgery
Volume113
Issue number1
DOIs
Publication statusPublished - Jan 2004

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Perforator Flap
Iliac Artery
Transplants
Bone and Bones
Skin
Tissue Donors
Osteonecrosis
Contracture
Thigh
Dissection
Morbidity
Infection

ASJC Scopus subject areas

  • Surgery

Cite this

Sequential vascularized iliac bone graft and a superficial circumflex iliac artery perforator flap with a single source vessel for established mandibular defects. / Koshima, Isao; Namba, Yuzaburo; Tsutsui, Tetsuya; Itoh, Seiko.

In: Plastic and Reconstructive Surgery, Vol. 113, No. 1, 01.2004, p. 101-106.

Research output: Contribution to journalArticle

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